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Full text of "Rapid Population Growth Consequences And Policy Implications"

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(31, 32), requires only 240 doctors (less than 0.2 doctor per 100,000 population; about 1 percent of all doctors but 5 percent of female doctors). It creates new and socially important work (300 jobs in 1966; 2,460 by 1975) for the small but growing group of female matriculates for whom real job alternatives to childbearing are critical.
The program has also given part-time employment during 1965-1970 to tens of thousands of village midwives (dais) and other village women (and men) to be local contraceptive supply and referral agents. Because most countries traditionally employ females as nurses, health visitors, and midwives, health services are one of the potential sources of greater employment for females in the future. Perhaps more by serendipity than by design, such greater employment of women is also an important indirect natality control measure which could be purposefully expanded. The impossibility of depending upon the pool of female doctors, lady health visitors, and nurse-midwives to provide necessary family planning manpower (e.g., about two doctors per 100,000 population) is well documented in a report from India (33).
No additional requirements for hospital beds result from family planning; rather, in those countries where illegal induced abortion is already so widely practiced that the aftereffects now utilize a sizeable proportion of hospital beds, a case can be made that family planning will result in additional specific savings in bed requirements beyond that related to reduced natality on population growth. On the other hand, if abortion is legalized in more countries, and is both acceptable and accessible, demand for short-term hospital care may increase. Current techniques of aspiration already minimize this demand. It is impossible to predict whether there would be a net increase or a net decrease because of the reduced bed and medical needs to care for complications now ensuing after illegal abortions combined with additional needs created by more legalized, hospital-performed abortions. A large postpartum sterilization program would also increase the need for hospital beds and related services.
The effect of family planning on requirements for other health services, such as maternal and child health, is assumed to be unimportant in most LDC's because demand for other services will greatly exceed the supply under any foreseeable circumstances in the next 20 years. In those few countries with a high ratio of trained midwives to population, reductions in natality rates might result in transient or further underemployment of midwives. In that case the trained midwives would presumably provide family planning services and use of their nursing services would increase as a result of public satisfaction with family planning services from the same source. It seems realistic to treat most family planning requirements during the next two decades as additional to those for other health services, and to assume that the overall effect of adding family planning on requirements for traditional health manpower and facilities will be small in most LDC's.